High Cholesterol and Stress: What’s the Connection?

The information in this article is not intended to replace professional medical advice, diagnosis, or treatment. Instead, consult your physician or any licensed healthcare providers if you have medical questions to get personalized answers.

You may often hear about the dangers of high cholesterol for the heart, but did you know it could also impact your mental well-being? It turns out that the relationship between cholesterol and stress is a two-way street. This means high cholesterol can potentially influence the development of stress and anxiety, the same way mood disorders can contribute to the increase of cholesterol levels. Continue reading to know the mechanisms of this significant connection. 

How Does Stress and Anxiety Impact High Cholesterol?

Although the link between stress and high cholesterol might not be immediately apparent, there is a growing body of evidence suggesting a strong connection.

A 2023 study underscored the role of cholesterol metabolism in maintaining healthy brain function⁽¹⁾. It was also emphasized that disruptions in this process are strongly linked to neuropsychiatric disorders like anxiety and depression. Cholesterol imbalances can cause and exacerbate these disorders, creating a vicious cycle. 

While other factors contribute to these conditions, abnormal cholesterol metabolism significantly impacts neuronal health, leading to cell death, structural abnormalities, and impaired function. When you experience stress, your body initiates a fight-or-flight response. This triggers the release of hormones like cortisol (stress hormone) and adrenaline (emergency hormone). 

Increased triglycerides

Stress hormones stimulate the production of triglycerides⁽²⁾, a type of fat that circulates in your blood and serves as an energy source. Chronically elevated levels due to persistent stress can lead to a buildup of LDL cholesterol, often called “bad” cholesterol. This increase in LDL cholesterol is a significant risk factor for heart disease as it contributes to the formation of plaque in your arteries, potentially leading to blockages and cardiovascular complications.

Also Read: Making Sense of High Cholesterol Warning Signs

Reduced HDL cholesterol 

HDL cholesterol is referred to as the “good cholesterol” because it picks up excess LDL cholesterol from the bloodstream and transports it back to the liver for processing and removal. This process helps prevent plaque buildup in the arteries, reducing the risk of heart disease. 

However, during a stressful situation, the body releases hormones like cortisol⁽³⁾, which can interfere with this balance. Cortisol can lower HDL cholesterol levels, making it less efficient at clearing out LDL cholesterol. This, in turn, increases the risk of LDL cholesterol accumulating in the arteries, potentially leading to blockages and cardiovascular problems. 

Unhealthy coping mechanisms 

Individuals may adopt unhealthy coping mechanisms to seek relief, albeit temporarily, when faced with stress. These mechanisms, while providing a momentary escape from stressors, often contribute to high cholesterol and exacerbate health risks. 

Overeating, for instance, can lead to weight gain and elevated levels of triglycerides and LDL cholesterol. Smoking, a known risk factor for cardiovascular disease, damages blood vessels⁽⁴⁾ and increases the likelihood of plaque buildup⁽⁵⁾, further contributing to high cholesterol. Excessive alcohol consumption also disrupts lipid metabolism⁽⁶⁾, leading to increased triglyceride levels and potentially raising LDL cholesterol. 

Also Read: 5 Unhealthy Ways to Cope With Stress You Think Are Okay

Disrupted sleep

Stress can significantly disrupt sleep patterns, leading to poor sleep quality and quantity. This lack of restful sleep triggers a flow of hormonal imbalances⁽⁷⁾, including increased cortisol and ghrelin (an appetite-stimulating hormone) while simultaneously decreasing leptin (which regulates body weight). 

This hormonal disruption can negatively impact how your body processes and regulates cholesterol, often resulting in elevated levels of LDL cholesterol and triglycerides, increasing the risk of heart disease. Furthermore, poor sleep can contribute to unhealthy lifestyle choices⁽⁸⁾, such as overeating or decreased physical activity, further exacerbating cholesterol problems.

Also Read: 7 Science-Backed Tips To Sleep Better if You Have Anxiety

Impaired liver function

The liver helps regulate cholesterol levels, and chronic stress can interrupt this process. The constant influx of stress hormones like cortisol can impair the liver’s ability to efficiently process cholesterol. This can lead to an overproduction of LDL cholesterol, increasing the risk of heart disease. Thus, habits that destroy your liver function must be regulated, which include stress-inducing activities. 

How High Cholesterol Influences Stress and Anxiety? 

Earlier studies forge the connection between stress and high cholesterol levels from how the former affects the latter. However, developing research has traced the impact of high cholesterol to the susceptibility of quickly forming symptoms of psychological distress and disorders. 

A recent review by the University of Queensland highlights the role of neurolipids in anxiety⁽⁹⁾. These fats are essential for brain function, and imbalances in their levels are linked to anxiety disorders. It shows the relationship between high cholesterol and stress is bilateral. 

That said, here’s how high cholesterol may potentially contribute to stress and anxiety:

Brain inflammation

High cholesterol can contribute to inflammation throughout the body, including the brain. When cholesterol levels are elevated, it can contribute to the buildup of plaque in blood vessels, restricting blood flow and promoting inflammation in various tissues.

This neuroinflammation, characterized by the activation of immune cells and increased production of inflammatory molecules in the brain, is increasingly recognized as a significant contributor to mood disorders⁽¹⁰⁾ like anxiety and depression. 

Disrupted neurotransmitter function

Cholesterol influences the production and activity of essential neurotransmitters like serotonin and dopamine. These chemical messengers regulate mood, emotions, and overall mental well-being. Elevated cholesterol levels can disrupt this neurotransmitter system, potentially leading to imbalances that manifest as anxiety, depression, and other mood disorders.  

Gut-brain axis disruption

Emerging research reveals a fascinating connection between cholesterol, gut health, and mental well-being⁽¹¹⁾. This suggests that high cholesterol can disrupt the balance of the gut microbiome. 

When high cholesterol negatively impacts the gut microbiome, it can influence brain function, leading to imbalances in neurotransmitter production and activity. It can potentially contribute to the development or exacerbation of anxiety and depression.

Did You Know? You can book a Cholesterol Follow-Up Blood Test online to check if you have successfully lowered cholesterol after following your doctor’s recommendation and prescription. The test provides a snapshot of the necessary change that can further improve your mental wellness. 

The Bottom Line

Being aware of the connection between mood disorders and elevated lipids can give you leverage on how to properly manage your health. Moderation emerges as a guiding principle in mitigating the risks associated with high cholesterol and stress. For instance, adopting a balanced diet rich in fruits, vegetables, and whole grains while limiting processed foods, sugary drinks, and unhealthy fats can significantly contribute to maintaining healthy cholesterol levels. Equally important is incorporating stress management techniques into our daily routines. 

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² Chourpiliadis C, Zeng Y, Lovik A, Wei D, Valdimarsdóttir U, Song H, Hammar N, Fang F. Metabolic Profile and Long-Term Risk of Depression, Anxiety, and Stress-Related Disorders. JAMA Netw Open. 2024 Apr 1;7(4):e244525. doi: 10.1001/jamanetworkopen.2024.4525. PMID: 38564219; PMCID: PMC10988352.

³ Knezevic E, Nenic K, Milanovic V, Knezevic NN. The Role of Cortisol in Chronic Stress, Neurodegenerative Diseases, and Psychological Disorders. Cells. 2023 Nov 29;12(23):2726. doi: 10.3390/cells12232726. PMID: 38067154; PMCID: PMC10706127.

⁴ Parmar MP, Kaur M, Bhavanam S, Mulaka GSR, Ishfaq L, Vempati R, C MF, Kandepi HV, Er R, Sahu S, Davalgi S. A Systematic Review of the Effects of Smoking on the Cardiovascular System and General Health. Cureus. 2023 Apr 24;15(4):e38073. doi: 10.7759/cureus.38073. PMID: 37234135; PMCID: PMC10208588.

⁵ Ishida M, Sakai C, Kobayashi Y, Ishida T. Cigarette Smoking and Atherosclerotic Cardiovascular Disease. J Atheroscler Thromb. 2024 Mar 1;31(3):189-200. doi: 10.5551/jat.RV22015. Epub 2024 Jan 14. PMID: 38220184; PMCID: PMC10918046.

⁶ Li Q, Wang O, Ji B, Zhao L, Zhao L. Alcohol, White Adipose Tissue, and Brown Adipose Tissue: Mechanistic Links to Lipogenesis and Lipolysis. Nutrients. 2023 Jun 29;15(13):2953. doi: 10.3390/nu15132953. PMID: 37447280; PMCID: PMC10346806.

⁷ Pan Y, Zhou Y, Shi X, He S, Lai W. The association between sleep deprivation and the risk of cardiovascular diseases: A systematic meta‑analysis. Biomed Rep. 2023 Sep 12;19(5):78. doi: 10.3892/br.2023.1660. PMID: 37829258; PMCID: PMC10565718.

⁸ Akhlaghi M, Kohanmoo A. Sleep deprivation in development of obesity, effects on appetite regulation, energy metabolism, and dietary choices. Nutr Res Rev. 2023 Oct 31:1-21. doi: 10.1017/S0954422423000264. Epub ahead of print. PMID: 37905402.

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¹⁰ Guo B, Zhang M, Hao W, Wang Y, Zhang T, Liu C. Neuroinflammation mechanisms of neuromodulation therapies for anxiety and depression. Transl Psychiatry. 2023 Jan 9;13(1):5. doi: 10.1038/s41398-022-02297-y. PMID: 36624089; PMCID: PMC9829236.

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